Parameters predicting response to alpha-interferon treatment in chronic hepatitis C

Background/Aims: Sustained response to alpha-interferon treatment for chronic hepatitis C is seen in only 25% of cases. Therefore, it is desirable to define pretreatment factors predicting responders. Materials and methods: Forty-nine patients with chronic hepatitis C were treated with a standard alpha-interferon. regimen. (3 x 3 MU s.c./week). Demographic, biochemical and immunological parameters, and HCV genotypes were obtained prior to initiation. of treatment and evaluated for their value in. predicting response to alpha-interferon, therapy. Results: Response, as defined by normalization of ALT, was 71% during interferon therapy and sustained response after discontinuation of interferon 24.5%. Patients infected with HCV-genotype Ib had significantly more often ''community-acquired'' disease. Their outcome was worse with a response rate of 44% during therapy and a sustained response of 12.5%, as compared to 87% and 27% respectively in patients infected with genotypes other than Ib. On, multivariate analysis, absence of cirrhosis, HCV-genotype other than. Ib, higher ALT levels and higher numbers of CD8 positive liver infiltrates were found to be predictors of response during alpha-interferon. therapy. Conclusion: Response to alpha-interferon therapy seems to be influenced both by viral virulence factors and by the intensity of the host immune response to HCV.